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Smoking does not affect every socioeconomic subgroup of the population equally, resulting in major inequalities in terms of smoking-related morbidity and mortality. While previous studies mainly focused on inequalities in smoking prevalence, we have analysed the socioeconomic dimensions that might be associated with

Smoking does not affect every socioeconomic subgroup of the population equally, resulting in major inequalities in terms of smoking-related morbidity and mortality. While previous studies mainly focused on inequalities in smoking prevalence, we have analysed the socioeconomic dimensions that might be associated with two other smoking-related outcomes: the odds of successfully quitting and the duration of abstinence. Using nationally representative Swiss data, we found evidence of a socioeconomic gradient in successful cessation and abstinence duration with respect to education level and income for both men and women.
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Prevalence of childhood obesity and its complications have increased world-wide. Parental status may be associated with children’s health outcomes including their eating habits, body weight and blood cholesterol. The National Health and Nutrition Examination Survey (NHANES) for the years 1988–1994, provided a unique

Prevalence of childhood obesity and its complications have increased world-wide. Parental status may be associated with children’s health outcomes including their eating habits, body weight and blood cholesterol. The National Health and Nutrition Examination Survey (NHANES) for the years 1988–1994, provided a unique opportunity for matching parents to children enabling analyses of joint demographics, racial differences and health indicators. Specifically, the NHANES III data, 1988–1994, of 219 households with single-parents and 780 dual-parent households were analyzed as predictors for primary outcome variables of children’s Body Mass Index (BMI), dietary nutrient intakes and blood cholesterol. Children of single-parent households were significantly (p < 0.01) more overweight than children of dual-parent households. Total calorie and saturated fatty acid intakes were higher among children of single-parent households than dual-parent households (p < 0.05). On average, Black children were more overweight (p < 0.04) than children of other races. The study results implied a strong relationship between single-parent status and excess weight in children. Further studies are needed to explore the dynamics of single-parent households and its influence on childhood diet and obesity. Parental involvement in the development of school- and community-based obesity prevention programs are suggested for effective health initiatives. Economic constraints and cultural preferences may be communicated directly by family involvement in these much needed public health programs.
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The role of nutritional factors in arsenic metabolism and toxicity is yet to be fully elucidated. A low protein diet results in decreased excretion of DMA and increased tissue retention of arsenic in experimental studies. Malnourished women carry a higher risk of adverse

The role of nutritional factors in arsenic metabolism and toxicity is yet to be fully elucidated. A low protein diet results in decreased excretion of DMA and increased tissue retention of arsenic in experimental studies. Malnourished women carry a higher risk of adverse pregnancy outcomes. Chronic exposure to high arsenic (>50 µg/L) through drinking water also increases the risk of adverse pregnancy outcomes. The synergistic effects (if any) of malnutrition and chronic arsenic exposure may worsen the adverse pregnancy outcomes. This population based case control study reports the association between chronic arsenic exposure and nutritional status among the rural women in Bangladesh. 348 cases (BMI < 18.5) and 360 controls (BMI 18.5–24.99) were recruited from a baseline survey conducted among 2,341 women. An excess risk for malnutrition was observed among the participants chronically exposed to higher concentrations of arsenic in drinking water after adjusting for potential confounders such as participant’s age, religion, education, monthly household income and history of oral contraceptive pills. Women exposed to arsenic >50 µg/L were at 1.9 times (Odds Ratio = 1.9, 95% CI = 1.1–3.6) increased risk of malnutrition compared to unexposed. The findings of this study suggest that chronic arsenic exposure is likely to contribute to poor nutritional status among women of 20–45 years.
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The relationship between the incidence of norovirus-associated gastroenteritis outbreaks (NAGOs) in Victoria, Australia for the period 2002–2007 and rainfall was examined. Statistical analysis involving the correlation between time series indicated that there was a statistically significant (p

The relationship between the incidence of norovirus-associated gastroenteritis outbreaks (NAGOs) in Victoria, Australia for the period 2002–2007 and rainfall was examined. Statistical analysis involving the correlation between time series indicated that there was a statistically significant (p < 0.05) correlation between monthly NAGO incidence and average monthly rainfall. There was a lag of an average of about three months between peak average rainfall and a NAGO epidemic. The findings thus indicate rainfall can influence NAGO incidence. In an era where there is concern about the potential effects of global warming on weather patterns, it should be borne in mind that future changes in NAGO incidence may reflect altered world weather patterns.
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There have been anecdotal reports of increases in birth defects and cancer in Fallujah, Iraq blamed on the use of novel weapons (possibly including depleted uranium) in heavy fighting which occurred in that town between US led forces and local elements in 2004.

There have been anecdotal reports of increases in birth defects and cancer in Fallujah, Iraq blamed on the use of novel weapons (possibly including depleted uranium) in heavy fighting which occurred in that town between US led forces and local elements in 2004. In Jan/Feb 2010 the authors organised a team of researchers who visited 711 houses in Fallujah, Iraq and obtained responses to a questionnaire in Arabic on cancer, birth defects and infant mortality. The total population in the resulting sample was 4,843 persons with and overall response rate was better than 60%. Relative Risks for cancer were age-standardised and compared to rates in the Middle East Cancer Registry (MECC, Garbiah Egypt) for 1999 and rates in Jordan 1996–2001. Between Jan 2005 and the survey end date there were 62 cases of cancer malignancy reported (RR = 4.22; CI: 2.8, 6.6; p < 0.00000001) including 16 cases of childhood cancer 0-14 (RR = 12.6; CI: 4.9, 32; p < 0.00000001). Highest risks were found in all-leukaemia in the age groups 0-34 (20 cases RR = 38.5; CI: 19.2, 77; p < 0.00000001), all lymphoma 0–34 (8 cases, RR = 9.24;CI: 4.12, 20.8; p < 0.00000001), female breast cancer 0–44 (12 cases RR = 9.7;CI: 3.6, 25.6; p < 0.00000001) and brain tumours all ages (4 cases, RR = 7.4;CI: 2.4, 23.1; P < 0.004). Infant mortality was based on the mean birth rate over the 4 year period 2006–2009 with 1/6th added for cases reported in January and February 2010. There were 34 deaths in the age group 0–1 in this period giving a rate of 80 deaths per 1,000 births. This may be compared with a rate of 19.8 in Egypt (RR = 4.2 p < 0.00001) 17 in Jordan in 2008 and 9.7 in Kuwait in 2008. The mean birth sex-ratio in the recent 5-year cohort was anomalous. Normally the sex ratio in human populations is a constant with 1,050 boys born to 1,000 girls. This is disturbed if there is a genetic damage stress. The ratio of boys to 1,000 girls in the 0–4, 5–9, 10–14 and 15–19 age cohorts in the Fallujah sample were 860, 1,182, 1,108 and 1,010 respectively suggesting genetic damage to the 0–4 group (p < 0.01). Whilst the results seem to qualitatively support the existence of serious mutation-related health effects in Fallujah, owing to the structural problems associated with surveys of this kind, care should be exercised in interpreting the findings quantitatively.
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Due to international migration, health care professionals in Switzerland increasingly encounter language barriers in communication with their patients. In order to examine health professionals’ attitudes and practices related to healthcare interpreting, we sent a self-administered questionnaire to heads of medical and nursing departments

Due to international migration, health care professionals in Switzerland increasingly encounter language barriers in communication with their patients. In order to examine health professionals’ attitudes and practices related to healthcare interpreting, we sent a self-administered questionnaire to heads of medical and nursing departments in public healthcare services in the canton of Basel-Stadt (N = 205, response rate 56%). Strategies used to communicate with foreign-language speaking patients differed, depending on the patient’s language. While nearly half of respondents relied on patients’ relatives to translate for Albanian, Tamil, Bosnian, Croatian, Serbian, Portuguese and Turkish, a third did so for Spanish, and a fourth did so for Arabic. Eleven percent relied on professional interpreters for Spanish and 31% did so for Tamil and Arabic. Variations in strategies used appear to mainly reflect the availability of bilingual staff members for the different languages. Future efforts should focus on sensitizing health professionals to the problems associated with use of ad hoc interpreters, as well as facilitating access to professional interpreters.
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Pregnant mice (n = 3) were exposed to BPA by intraperitoneal injection, from gestation day 9.5 until end of lactation. Male offspring were evaluated for cytokine production at 20 wk-of-age. One pregnant control mouse produced no males, precluding statistical analysis. However, recurring shifts

Pregnant mice (n = 3) were exposed to BPA by intraperitoneal injection, from gestation day 9.5 until end of lactation. Male offspring were evaluated for cytokine production at 20 wk-of-age. One pregnant control mouse produced no males, precluding statistical analysis. However, recurring shifts in cytokines were suggested in the adult BPA offspring. Serum showed a numeric increase in 16 of 21 basal cytokine levels. ConA-stimulated splenocytes showed a numeric increase in 17 of 21 cytokines, and LPS-stimulated splenocytes an increase in 18 of 21 cytokines. The cytokine profile was one of TH1 up-regulation more than TH2, and with skewing toward TH17 responses.
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This study assessed the physical activity (PA) levels and its variability across days, months and seasons of two groups of high school pupils: those who did and those who did not participate in regular organized after-school physical activity (ASPA). Thirteen pupils wore pedometers

This study assessed the physical activity (PA) levels and its variability across days, months and seasons of two groups of high school pupils: those who did and those who did not participate in regular organized after-school physical activity (ASPA). Thirteen pupils wore pedometers continuously for one school-year, logged their step counts into record sheets and were then interviewed for information as regards their participation in any ASPA. Repeated measures analysis of variance showed that regardless of the day, month and season, ASPA pupils achieved significantly more mean step counts/day than the non-ASPA pupils. There were no significant fluctuations across months and seasons in PA levels of ASPA pupils when compared to non-ASPA pupils. We conclude that regular organised ASPA might increase the pupils’ total PA levels; and could help to maintain a relatively constant PA level for adolescents across the whole school-year regardless of the influences of a range of weather and meteorological indicators that are related to months/seasons.
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There is a growing interest in quantifying the health impacts of climate change. This paper examines the risks of future ozone levels on non-accidental mortality across 19 urban communities in Southeastern United States. We present a modeling framework that integrates data from climate

There is a growing interest in quantifying the health impacts of climate change. This paper examines the risks of future ozone levels on non-accidental mortality across 19 urban communities in Southeastern United States. We present a modeling framework that integrates data from climate model outputs, historical meteorology and ozone observations, and a health surveillance database. We first modeled present-day relationships between observed maximum daily 8-hour average ozone concentrations and meteorology measured during the year 2000. Future ozone concentrations for the period 2041 to 2050 were then projected using calibrated climate model output data from the North American Regional Climate Change Assessment Program. Daily community-level mortality counts for the period 1987 to 2000 were obtained from the National Mortality, Morbidity and Air Pollution Study. Controlling for temperature, dew-point temperature, and seasonality, relative risks associated with short-term exposure to ambient ozone during the summer months were estimated using a multi-site time series design. We estimated an increase of 0.43 ppb (95% PI: 0.14–0.75) in average ozone concentration during the 2040’s compared to 2000 due to climate change alone. This corresponds to a 0.01% increase in mortality rate and 45.2 (95% PI: 3.26–87.1) premature deaths in the study communities attributable to the increase in future ozone level.
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This study estimates the avoidable and unavoidable costs of alcohol-related, liver cirrhosis inpatient care, controlling for the lag structure and period of decline in disease risk. Lag structures with different lengths are applied to the exposure to risk from alcohol consumption, which allows

This study estimates the avoidable and unavoidable costs of alcohol-related, liver cirrhosis inpatient care, controlling for the lag structure and period of decline in disease risk. Lag structures with different lengths are applied to the exposure to risk from alcohol consumption, which allows for differentiation between avoidable and unavoidable cases due to prior consumption. A lag length of 20 (men) and 23 (women) years (expected remaining life years) gives a total cost of 592 million SEK. Given alcohol consumption is reduced to zero, 72% of cost could potentially be avoided. It is important to account for the length and structure of the risk decline following a consumption change as this substantially affects the estimates.
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Pre-cessation reduction is associated with quitting smoking. However, many smokers reduce the amount consumed but may not quit altogether. Using a representative sample of adult current daily smokers, this project explored future intentions of smokers regarding cigarette consumption. This information is important because

Pre-cessation reduction is associated with quitting smoking. However, many smokers reduce the amount consumed but may not quit altogether. Using a representative sample of adult current daily smokers, this project explored future intentions of smokers regarding cigarette consumption. This information is important because it can provide a framework within which to plan tobacco cessation initiatives. A random digit dialing telephone survey was conducted of 889 Canadian current daily smokers, 18 years and older. The response rate was 65% (of households with a smoker in residence, 65% agreed to participate). Analyses focused on the 825 respondents who smoked at least 10 cigarettes per day at some point in their lives. As part of this survey, respondents were asked their future plans about their smoking (maintain, increase, reduce, quit).Of these 825 respondents, the majority of respondents had plans to change their cigarette use, with 55% planning to quit, 18.8% to reduce and 22.5% to maintain the amount they smoked (3.4% did not know and 2 respondents planned to increase). Most smokers who planned to reduce their smoking saw it as a step towards quitting smoking completely.These results present a picture of smokers, the majority of whom appear to be in some form of transition. Many smokers planned to reduce, of which the overwhelming majority saw their reduction as a step towards quitting. Opportunities exist to capitalize on these intentions to change in efforts to promote tobacco cessation.
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Human biomonitoring of plasma and urinary levels of nicotine, cotinine, and 3′-hydroxycotinine was conducted after daily cigarette smoking in a population of 92 male Japanese smokers with a mean age of 37 years who had smoked an average of 23 cigarettes per day

Human biomonitoring of plasma and urinary levels of nicotine, cotinine, and 3′-hydroxycotinine was conducted after daily cigarette smoking in a population of 92 male Japanese smokers with a mean age of 37 years who had smoked an average of 23 cigarettes per day for 16 years. Members of the population were genotyped for the nicotine-metabolizing enzyme cytochrome P450 2A6 (CYP2A6). The mean levels of nicotine, the levels of its metabolites cotinine and 3′-hydroxycotinine, and the sum of these three levels in subjects one hour after smoking the first cigarette on the sampling day were 20.1, 158, 27.7, and 198 ng/mL in plasma and 846, 1,020, 1,010, and 2,870 ng/mL in urine under daily smoking conditions. Plasma levels of 3'-hydroxycotinine and urinary levels of nicotine and 3′-hydroxycotinine were dependent on the CYP2A6 phenotype group, which was estimated from the CYP2A6 genotypes of the subjects, including those with whole gene deletion. Plasma cotinine levels were significantly correlated with the number of cigarettes smoked on the day before sampling (r = 0.71), the average number of cigarettes smoked daily (r = 0.58), and the Brinkman index (daily cigarettes × years, r = 0.48) under the present conditions. The sum of nicotine, cotinine, and 3′-hydroxycotinine concentrations in plasma showed a similar relationship to that of the plasma cotinine levels. Urinary concentrations of cotinine and the sum of nicotine metabolite concentrations also showed significant correlations with the plasma levels and the previous day’s and average cigarette consumption. The numbers of cigarettes smoked per day by two subjects with self-reported light smoking habits were predicted by measuring the urinary cotinine concentrations and using linear regression equations derived from above-mentioned data. These results indicate that biomonitoring of the urinary cotinine concentration is a good, easy-to-use marker for plasma levels of cotinine and the sum of nicotine metabolites in smokers independent of genetic polymorphism of CYP2A6.
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The potential development of heat-related mortality in the 21th century for Vienna (Austria) was assessed by the use of two regional climate models based on the IPCC emissions scenarios A1B and B1. Heat stress was described with the human-biometeorological index PET (Physiologically Equivalent

The potential development of heat-related mortality in the 21th century for Vienna (Austria) was assessed by the use of two regional climate models based on the IPCC emissions scenarios A1B and B1. Heat stress was described with the human-biometeorological index PET (Physiologically Equivalent Temperature). Based on the relation between heat stress and mortality in 1970–2007, we developed two approaches to estimate the increases with and without long-term adaptation. Until 2011–2040 no significant changes will take place compared to 1970–2000, but in the following decades heat-related mortality could increase up to 129% until the end of the century, if no adaptation takes place. The strongest increase occurred due to extreme heat stress (PET ≥ 41 °C). With long-term adaptation the increase is less pronounced, but still notable. This encourages the requirement for additional adaptation measurements.
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Welding is a major industrial process used for joining metals. Occupational exposure to welding fumes is a serious occupational health problem all over the world. The degree of risk to welder’s health from fumes depends on composition, concentration, and the length of exposure.

Recent evidence suggests that endocrine disrupting chemicals (EDCs) may cause perturbations in endogenous hormonal regulation that predispose to weight gain. Using data from NHANES (1999–2002), we investigated the association between body mass index (BMI), waist circumference (WC) and selected persistent organic pollutants (POPs) via multiple linear regressions. Consistent interaction was found between gender, ln oxychlordane and ln p,p’ DDT. Also, we found an association between WC and ln oxychlordane and ln hpcdd in subjects with detectable levels of POPs, whereas an association between WC and ln p,p’ DDT was observed in all subjects. Furthermore, ln Ocdd showed an increase with higher WC and BMI, whereas, ln trans-nonachlor decreased with higher BMI. Hence, BMI and WC are associated with POPs levels, making the chemicals plausible contributors to the obesity epidemic.
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Chelation therapy is the preferred medical treatment for reducing the toxic effects of metals. Chelating agents are capable of binding to toxic metal ions to form complex structures which are easily excreted from the body removing them from intracellular or extracellular spaces. 2,3-Dimercaprol

Chelation therapy is the preferred medical treatment for reducing the toxic effects of metals. Chelating agents are capable of binding to toxic metal ions to form complex structures which are easily excreted from the body removing them from intracellular or extracellular spaces. 2,3-Dimercaprol has long been the mainstay of chelation therapy for lead or arsenic poisoning, however its serious side effects have led researchers to develop less toxic analogues. Hydrophilic chelators like meso-2,3-dimercaptosuccinic acid effectively promote renal metal excretion, but their ability to access intracellular metals is weak. Newer strategies to address these drawbacks like combination therapy (use of structurally different chelating agents) or co-administration of antioxidants have been reported recently. In this review we provide an update of the existing chelating agents and the various strategies available for the treatment of heavy metals and metalloid intoxications.
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Both the recent classification of naphthalene as a possible human carcinogen and its ubiquitous presence motivate this critical review of naphthalene’s sources and exposures. We evaluate the environmental literature on naphthalene published since 1990, drawing on nearly 150 studies that report emissions and

Both the recent classification of naphthalene as a possible human carcinogen and its ubiquitous presence motivate this critical review of naphthalene’s sources and exposures. We evaluate the environmental literature on naphthalene published since 1990, drawing on nearly 150 studies that report emissions and concentrations in indoor, outdoor and personal air. While naphthalene is both a volatile organic compound and a polycyclic aromatic hydrocarbon, concentrations and exposures are poorly characterized relative to many other pollutants. Most airborne emissions result from combustion, and key sources include industry, open burning, tailpipe emissions, and cigarettes. The second largest source is off-gassing, specifically from naphthalene’s use as a deodorizer, repellent and fumigant. In the U.S., naphthalene’s use as a moth repellant has been reduced in favor of para-dichlorobenzene, but extensive use continues in mothballs, which appears responsible for some of the highest indoor exposures, along with off-label uses. Among the studies judged to be representative, average concentrations ranged from 0.18 to 1.7 μg m-3 in non-smoker’s homes, and from 0.02 to 0.31 μg m-3 outdoors in urban areas. Personal exposures have been reported in only three European studies. Indoor sources are the major contributor to (non-occupational) exposure. While its central tendencies fall well below guideline levels relevant to acute health impacts, several studies have reported maximum concentrations exceeding 100 μg m-3, far above guideline levels. Using current but draft estimates of cancer risks, naphthalene is a major environmental risk driver, with typical individual risk levels in the 10-4 range, which is high and notable given that millions of individuals are exposed. Several factors influence indoor and outdoor concentrations, but the literature is inconsistent on their effects. Further investigation is needed to better characterize naphthalene’s sources and exposures, especially for indoor and personal measurements.
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Biomass fuel burning leads to high levels of suspended particulate matter and hazardous chemicals in the indoor environment in countries where it is in common use, contributing significantly to indoor air pollution (IAP). A situational analysis of household energy and biomass use and

Biomass fuel burning leads to high levels of suspended particulate matter and hazardous chemicals in the indoor environment in countries where it is in common use, contributing significantly to indoor air pollution (IAP). A situational analysis of household energy and biomass use and associated health effects of IAP was conducted by reviewing published and un-published literature about the situation in Pakistan. In addition to attempt to quantify the burden of ill health due to IAP, this paper also appraises the mitigation measures undertaken to avert the problem in Pakistan. Unfortunately, IAP is still not a recognized environmental hazard in Pakistan and there are no policies and standards to control it at the household level. Only a few original studies related to health effects of IAP have been conducted, mainly on women’s health and birth outcome, and only a few governmental, non-governmental and academic institutions are working to improve the IAP situation by introducing improved stoves and renewable energy technology at a small scale. Control of IAP health hazards in Pakistan requires an initial meeting of the stakeholders to define a policy and an action agenda. Simultaneously, studies gathering evidence of impact of intervention through available technologies such as improved stoves would have favorable impact on the health, especially of women and children in Pakistan.
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